Comparison of resorbable soft tissue fillers

Abstract

Soft tissue fillers for wrinkle treatment and facial reshaping offer numerous advantages for both doctors and patients. They are extremely well tolerated and efficacious and can produce long-lasting improvement with regular use. In this article a detailed, thorough review of the resorbable injectable filler implants available on the international market is offered and the most suitable for various treatment areas are identified. The chemical nature, formulation, indications, recommendations for technique, and possible side effects of each family of fillers are described.

Delayed Immune-Mediated Adverse Effects of Polyalkylimide Dermal Fillers

“…19,20 Skin induration, nodules, and pseudo-abscesses have been reported with polyalkylimide. 1,7,14,15 Unlike other implant fillers, specific histologic granulomas related to PAIs have not yet been described. [19][20][21] Since becoming available in 2001, polyalkylimide is increasingly one of the most commonly used fillers in Europe.…”

“…[9][10][11][12][13] However, more recent evidence refutes these statements, and so the complete safety of PAI gels can no longer be assured. 1,7,14,15 We describe a cohort of patients with delayed adverse reactions to PAI fillers.…”

“…Although claims have been made that the fillers are nontoxic and nonimmunogenic and that complications are very uncommon, 3,4 adverse effects occur with the use of all compounds. 1,[5][6][7] Two deficiencies of dermal fillers are long-term safety and the reversibility of adverse effects. At present, acrylamide compounds, mainly polyalkylimide implants (PAIs), are increasingly used in Europe.…”

Long-term effects of glans penis augmentation using injectable hyaluronic acid gel for premature ejaculation

“…Although manufacturers and different publications claim that the fillers are non-toxic and non-immunogenic, or that complications are very uncommon, 11 unwanted side-effects occur with all compounds used. [12][13][14] In the early reports of HA injection for cosmetic purposes, no significant signs of bio-incompatibility were reported. 15,16 Recent evidence may show that major, local and/or systemic, immediate or delayed adverse effects may appear in relation with its use.…”

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

“…Chemical and particulate impurities have been blamed convincingly 10,26,28 because the foreign body granuloma rate of almost all filler substances has decreased as product improvements have been developed over the years. 10,66 Dormant allergens with low immunogenicity are able to produce a clinical response during the boost in the immune system that occurs with infections and with highly active antiretroviral therapy (immune reconstitution syndrome). The memory of macrophages and the mechanism of a later trigger such as infection or drugs could explain the unpredictability of foreign body granuloma (Fig.…”